Is Metabolic Syndrome Associated with the Risk of Recurrent Stroke: A Meta-Analysis of Cohort Studies

Abstract

Background: The association between metabolic syndrome (MetS) and recurrence of stroke remains unknown. We summarized the evidence by a meta-analysis of prospective cohort studies.

Methods: We searched the PubMed, EMBASE, and Google Scholar databases from their inception until July 2016 for cohort studies investigating this research question; relevant information was extracted by 2 independent investigators, and then aggregated using the random-effects meta-analysis approach.

Results: We identified 5 studies, including 7752 stroke patients who had a history of stroke or transient ischemic attack. Compared with persons without MetS, persons with MetS have a significantly higher risk of recurrent stroke, and the pooled relative risk (RR) was 1.52 (95% confidence interval (CI): 1.17-1.97). The strength of this association is greater than individual MetS components such as elevated blood pressure (RR = 1.05, 95% CI: .72-1.52), elevated triglycerides (RR = 1.04, 95% CI: .84-1.29), low high-density lipoprotein cholesterol (RR = 1.16, 95% CI: .91-1.48), or obesity (RR = 1.12, 95% CI: .89-1.41). The risk of recurrent stroke was highest in the group with elevated glycemia (RR = 1.70, 95% CI: 1.12-2.56).

Conclusions: This meta-analysis suggests that MetS might be an important predictor of recurrent stroke. Among the 5 components of MetS, elevated glycemia was a stronger predictor for recurrent stroke.

Keywords: Metabolic syndrome; cardiovascular diseases; meta-analysis; recurrent stroke.